Various types of surgery require a surgeon to place and temporarily secure a suture during a given surgical procedure. For example, prior to cannulation in cardiac surgery, surgeons often place one or more pursestring sutures around a target tissue site before an incision will be made for a cannula to be inserted. Then, after the incision is made at the target site and the cannula has been inserted, the one or more pursestring sutures are cinched to pull the tissue closed around the cannula to ensure there is a good seal around the cannula. Since the cannula will be removed before the end of the procedure, it is not efficient to tie a knot in the suture ends. Furthermore, given the increase in minimally invasive surgical techniques, the surgical team may not have direct access to the suture ends exiting the tissue, so it can be difficult to maintain a cinched pressure around the cannula.
One solution employed by surgeons in this situation is the use of a simple tube. The suture ends in need of temporary cinching are passed through a thin tube which reaches from the surgical site to a convenient location away from the surgical site. The distal end of the tube presses against the tissue where the sutures exit the tissue and, while holding the proximal end of the tube, the suture ends are pulled out of the proximal end of the tube to create a desired tension. Then, the proximal end of the tube is clamped to hold the sutures until it is time to release them. While workable, there is much room for improvement with these types of tube tourniquet solutions. It would be desirable to have an improved suture securing tube that reduces tissue trauma on the distal end, is more compatible with the limited space constraints presented in minimally invasive surgical techniques, and which provides additional options for the temporary securing of the suture ends passing out of the proximal end.